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    <title>临床资料</title>
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		<h5>临床资料:</h5>
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	<div id="patient" style="margin:20px 20px 0px 200px; border: dashed 1px  #777">
		<form action="PatientFormAdd" method="post">
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			<div class="doc">
				<span>简要病情:（包括症状、治疗及转诊等）</span>
			</div>
			<div><textarea name="b280" cols="90" rows="3"></textarea></div>
		
		        
		    <div class="doc"><span>
			   <s:checkboxlist name="b281"  list='#{1:"心律失常（包括治疗情况）："}' theme="simple" />
			   <input class="txt"  type="text" size="56" name="b282" />
			</span></div>
			
		    <div class="doc" ><span>
			   <s:checkboxlist name="b283" list='#{1:"起搏器术后："}'theme="simple"/>
			       安装时间 <input class="txt"  type="text" size="15" name="b284"/>
			       起搏方式 <input class="txt"  type="text" size="32" name="b285"/>
			</span></div> 

			<div class="doc"><span>
			   <s:checkboxlist name="b286" list='#{1:"伴随疾病诊治（包括治疗情况）："}' theme="simple" />
			   <input class="txt"  type="text" size="75" name="b287"/>
			</span></div>  

			<div class="doc"><span>
			   <s:checkboxlist name="b288" list='#{1:"其他（包括治疗情况）："}' theme="simple" />
			   <input class="txt"  type="text" size="60" name="b289"/>
			</span></div>  
			                  
		</div>
		
		<h5>目前治疗情况资料（包括药名、剂量、用法等）：</h5>
		<div>
			<div class="doc"><span>
			 1，CBB： <input class="txt"  type="text" size="76" name="b290"/>
			</span></div> 
			<div class="doc"><span>
			 2，	β-受体阻滞剂： <input class="txt"  type="text" size="67" name="b291"/>
			</span></div> 
			<div class="doc"><span>
			 3，	硝酸酯类： <input class="txt"  type="text" size="72" name="b292"/>
			</span></div>   
			<div class="doc"><span>
			 4，	ACEI/ARB： <input class="txt"  type="text" size="70" name="b293"/>
			</span></div>   
			<div class="doc"><span>
			 5，他汀类或其他 <input class="txt"  type="text" size="71" name="b294"/>
			</span></div>   
			<div class="doc"><span>
			 6，阿司匹林或其它 <input class="txt"  type="text" size="69" name="b295"/>
			</span></div> 
			<div class="doc"><span>
			 7，利尿剂：<input class="txt"  type="text" size="76" name="b296"/>
			</span></div>      
			<div class="doc"><span>
			 8，其他心血管病治疗药物<input class="txt"  type="text" size="64" name="b297"/>
			</span></div>  	
		</div>
		
		<div>
			<h5>特殊检查与评估资料</h5>
			<div class="doc">
				<span>尿蛋白（有条件时）：<input class="txt"  type="text" size="66" name="b298"/></span>              
			</div>
			                                 
			<div class="doc">
				<div><span>活动平板：<b>（可复印附上）</b></span></div>
				<div style="padding-left:20px">
					<span>运动时间：<input class="txt"  type="text" size="10" name="b299"/></span>   
					<span>代谢当量：<input class="txt"  type="text" size="10" name="b300"/></span>    
					<span>缺血阈： <input class="txt"  type="text" size="10" name="b301"/></span> 
				</div>   	         
			</div>
			                  
			<div class="doc">
				<span>6分钟步行距离：<input class="txt"  type="text" size="70" name="b302"/></span>              
			</div>                  
						                                
			<div class="doc">
				<span>UCG（可<B>复印附上图</B>）：</span>
				<span>EF：<input class="txt"  type="text" size="3" name="b303"/></span>                 
				<span>FS<input class="txt"  type="text" size="3" name="b304"/></span>    
				<span>Tei指数：<input class="txt"  type="text" size="3" name="b305"/></span>
				<span>E峰<input class="txt"  type="text" size="3" name="b306"/></span>
				<span>A峰<input class="txt"  type="text" size="3" name="b307"/></span>
			</div>           
		                       
			<div class="doc" style="padding-left:20px">
				<span>左房直径：<input class="txt"  type="text" size="6" name="b308"/></span>                 
				<span>左室直径：<input class="txt"  type="text" size="7" name="b309"/></span>    
				<span>室间隔厚度：<input class="txt"  type="text" size="6" name="b310"/></span>
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			<div style="padding-left:20px">
				<span>其他<input class="txt"  type="text" size="60" name="b311"/></span>
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				<span>ECG（<B>复印附上图</B>）: </span>
				<span>HR:<input class="txt"  type="text" size="10" name="b312"/></span>                 
				<span>ST压低<input class="txt"  type="text" size="40" name="b313"/></span>    
			</div>  
			                  
			<div class="doc">
				<span>DCG(有条件时记录或附复印资料)：<input class="txt"  type="text" size="55" name="b314"/></span>   
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		</form>
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